title: Medulloblastoma with extensive nodularity undergoing post-therapeutic maturation to a gangliocytoma: a case report and literature review.
abstract: We present a report of a 12-year-old boy diagnosed with medulloblastoma at 22 months of age. A gross total resection was performed followed by adjuvant systemic chemotherapy due to his young age; however, the tumor recurred locally in the posterior fossa 7 months later. The recurrent tumor was excised and he received craniospinal radiation with a boost given to the posterior fossa followed by high-dose chemotherapy. He remained disease free for approximately 10 years without major neurologic deficit and only mild cognitive impairment. A routine follow-up MRI of the brain revealed an enhancing mass. The patient underwent surgical debulking and pathological examination revealed no residual immature medulloblastoma cells but instead mature ganglion cells, consistent with a gangliocytoma. The apparent maturation of primitive medulloblastoma cells is a rare phenomenon, which may have ensued from the long-term effects of adjuvant therapies inducing advanced cellular maturation.
authors.affiliation: School of Medicine, Loma Linda University, Loma Linda, CA, USA. dchelliah@gmail.com
authors.forename: Daniel
authors.initials: D
authors.lastname: Chelliah
authors.forename: Christian
authors.initials: C
authors.lastname: Mensah Sarfo-Poku
authors.forename: Baldassarre D
authors.initials: BD
authors.lastname: Stea
authors.forename: Jennifer
authors.initials: J
authors.lastname: Gardetto
authors.forename: Jonathan
authors.initials: J
authors.lastname: Zumwalt
mesh_terms: D002528:Cerebellar Neoplasms / Q000175:diagnosis / Q000601:surgery*; D002648:Child; D005500:Follow-Up Studies; D005729:Ganglioneuroma / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D008297:Male; D008527:Medulloblastoma / Q000175:diagnosis / Q000601:surgery*; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000601:surgery*